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Dental Insurance

Visiting a dentist for treatment like dentures or root canal is quite expensive. Good news is these expenses can be claimed back through insurance policies. Most policies don't provide claims for dental treatment, but some plans have dental insurance available as an inclusive cover option. Dental Insurance in India is not available as a stand-alone policy. It is a part of various health insurance policies as an additional or an in-built option. There are some advantages of having dental insurance like an assured benefit on whitening of teeth, teeth bracing, and implantation. Also, there are discounts available on regular checkups. 

What is Dental Insurance?

The dental insurance plan is the insurance cover provided for dental surgeries like root canal and cavity filling, done under the supervision of medical professionals. It does not include cosmetic dentistry though. Only procedures which are preventive or diagnostic are covered. Filling of caries, tooth extractions, dentures, root canal procedures, and other such procedures are included in the cover. Dental insurance plans vary widely across providers. Some of the basic types are:

  • Direct Reimbursement Program - Under this, the policy providers reimburse a certain amount of the total cost of the dental procedures. It includes all types of dental procedures, and the policyholder can visit the dentist of their choice. It also provides an incentive for the patient to maintain their oral health.
  • UCR Programs - The plan also pays back a certain amount of money to the policyholder on dental surgeries. Still, these include only essential dental procedures, not the cosmetic ones, although the policyholder can visit the dentist of his choice.
  • Table or Schedule of Allowance programs pays a fixed amount of money for the dental procedure. There is a list of covered services for which the policy provider pays. The fixed amount is independent of the amount of money charged.
  • In capitation programs, the policy provider pays a fixed amount of money to the dentist-approved by the company for every person enrolled. The policyholder is treated for certain dental procedures free of cost. For other treatments, a co-payment is required.

Why Should One Choose Dental Insurance?

Below are the reasons listed for choosing dental insurance:

  • It provides free unlimited dentist consultations to the policyholder.
  • The policy covers digital X-rays, and OPG facilities for teeth to the person insured.
  • There is a discount on teeth scaling, whereas some policies provide it free of cost.
  • The policyholder has the benefit of whitening of teeth free of cost.
  • There is an assured benefit on tooth implantation and bracing.
  • There are discounts available on routine checkups.
  • It also has a benefit available in composite teeth fillings and amalgam.
  • Dental Insurance has a guaranteed benefit for steel crowns on the primary teeth
  • The policyholder can avail of the treatment of the infected tooth nerves.
  • When compared online with other plans, it is seen that most policies which provide dental insurance are more cost-effective
  • Dental insurance also covers tooth removal.
  • It also covers minor surgical procedures like a biopsy of teeth tissue and drainage of oral infections.
  • Mild infections and lesions are covered in the policy. It also provides cover for dentures and bridges that need some repair.
  • The plans are economical in comparison to non-dental plans.

Types of Dental Plans in India

Various dental policies offered by Indian insurance providers can be categorised under the below health insurance types:

  • Individual Health Policies: This insurance plan has dental insurance covered in their basic plan, premium covers, or additional benefits. For availing dental insurance, the policyholder has to pay additionally for this benefit.
  • Surgery and Critical Illness Policies: This policy is a standalone policy that covers the costs incurred during specific illnesses. Such plans might offer dental surgeries under critical medical conditions.
  • Family Floater Health Insurance Policies: Most of these plans have cashless payment. Hence, dental insurance is generally covered. In this plan, there is no need to pay additionally for availing dental insurance.
  • Preventive Healthcare Policies: Such plans cover preventive care like doctor visits, regular check-ups, consultation costs, and dentists.
  • Travel Insurance Policies: The plans cover for dental procedures incurred due to accidents occurred while traveling.
  • Personal Accident Cover: It also covers for accident and dental expenses due to accidents.

Best Dental Insurance Plans in India

Some of the best dental insurance plans which offer coverage for dental insurance as well are:-

  • Bajaj Allianz Health Guard Policy
  • Bharti Axa Smart Health
  • BSLI Saral Health Plan
  • HDFC Ergo Health Maxima Health
  • ICICI Prudential Health Saver
  • SBI Life Smart Insurance

Plan Name

Entry Age

Policy Tenure

Sum Insured

Medical Test

Bajaj Allianz Health Guard Policy

 

Minimum:18 years

Maximum: 65 years

Child:3 months-25 years

 

1 year

1.5 lakh- 10 lakh

Above 45 years

Bharti Axa Smart Health

 

Minimum:18 years

Maximum: 60 years

Child:9- days-23 years

 

1 year

2 lakh, 3 lakh, 5 lakh

-

Birla Sun Life Insurance Saral Health Plan

 

Minimum:18 years

Maximum:50 years

 

10 years

10 lakh

-

HDFC Ergo Health Maxima

Minimum: 91 days

Maximum:65 year

 

1 year

3 lakh

-

ICICI Prudential Health Saver

 

Minimum: 25 years

Maximum: 55 years

Child: 90 days

 

10/30 years

Rs 25 lakh

-

SBI Life Smart Group Health Insurance

 

Minimum:18 years

Maximum: 65 years

 

1 year

1 lakh-5 lakh

-

Dental Insurance Plans Explained

Let’s consider the below dental insurance plans offered by the different insurance providers in India.

Bajaj Allianz Health Guard Policy

 Available in two plan options, this policy can be chosen as an individual or family floater plan. The policy period is of 1 year with lifelong renewability benefit.

  • Basic Plan: The health insurance policy covers in-patient hospitalization expenses due to illness or accidents.
  • Dental Insurance: The plan covers dental surgery or treatments. But it doesn't cover hospitalization due to accidents for dental procedures.

Features of Bajaj Allianz Health Guard Policy

Some of the unique features are:

  • It offers pre-hospitalization for up to 60 days for pre-hospitalization.
  • For post-hospitalization, a period of 90 days will be covered.
  • In this policy, expenditures for hospitalization in a hospital which is not a network hospital are covered.
  • Ambulance charges are covered up to Rs 1000.
  • Daycare procedures up to 130 days are covered.
  • Pre-existing illnesses are covered after a waiting period of 48 months.
  • Accidental hospitalization will be covered after a waiting period of 30 days.

Benefits of Bajaj Allianz Health Guard Policy

Benefits of the policy are:

  • If for 4 years no claims are made, then the policyholder gets a free health checkup for specific diseases.
  • The policyholder can return the policy within 15 days and all premiums paid will be returned.
  • Sum insured to be availed range from Rs 1.5 lakh to 10 lakh.
  • Premiums paid have tax benefits which can be availed under section 80D of the IT Act.
  • Premiums remain fixed throughout the policy tenure.
  • At the time of renewing the policy, the sum insured can be increased
  • Health insurance from other companies can be transferred to Bajaj Allianz without losing the accrued benefits.
  • The health insurance policy offers rebates in premiums.

Exclusions of Bajaj Allianz Health Guard Policy

The policy exclusions are:

  • Treatment for self-inflicted injuries will not be paid.
  • Cost of hospitalization for diagnostics cannot be claimed.
  • Donor treatment for transplant is excluded.
  • Hospitalization related to nuclear hazards, radiation or biological hazards.
  • Medical expenditure when hospitalization is not necessary.
  • Non-allopathic treatments are not covered.
  • Treatment for mental disorders is excluded.
  • Attempted suicide.
  • Use of alcohol or drug.
  • AIDS or related illnesses are not covered.
  • Congenital externals are excluded permanently.
  • Cosmetic, aesthetic or related treatment.
  • Infertility and in vitro fertilization.
  • Hospitalization out of war, riot, strike, and nuclear weapons.

Bharti Axa Smart Health

It is an annual policy with a lifelong renewability option.

  • Basic Plan: The family health insurance policy covers medical costs for the entire family. It includes accident hospitalization, pre- and post-hospitalization, domiciliary treatment, costs, and critical procedures.
  • Dental Insurance: In this policy, dental treatment due to accidents is covered.

Features of Bharti Axa Smart Health

The policy comes with the following features:

  • The plan covers all types of hospitalization expenses after a 30-days waiting period.
  • It also covers domiciliary hospitalization
  • The policy covers Day-care treatment expenses
  • Pre and post-hospitalization expenses of 30 days and 60 days are covered respectively
  • Pre-existing diseases are after 4 continuous renewals
  • The policy covers organ transplantation
  • It provides hospital cash allowance for accommodation
  • The policy also covers home nursing
  • Ambulance charges can also be claimed
  • A 5% discount is available for claim-free years, and a maximum of up to 25% of the rebate can be available.

Benefits of Bharti Axa Smart Health

Some of the policy benefits include the following:

  • Critical illness cover is available for the policyholder.
  • Cashless hospitalization at 4,300 networks of hospitals across India
  • Daily cash cover is available for room rent
  • It has 24x7 claim assistance and an early settlement process
  • The policy has a dedicated claims handler.
  • It reimburses the cost of medical examination of 50% of the total cost at some hospitals.
  • Portability of other insurance policies is available.

Exclusions of Bharti Axa Smart Health

The policy doesn’t offer coverage for the following treatment:

  • Doesn't cover for HIV / AIDS and other related sexually transmitted diseases
  • It doesn't cover the cost of spectacles, contact lenses, hearing aids, etc.
  • Pre-existing diseases are not covered before 4 renewals.
  • Pregnancy and childbirth-related complications
  • Diseases within 30 days of the grace period of the policy
  • Chronic diseases are not covered
  • Treatment from unregistered medical practitioners
  • Alcohol and drug abuse-related hospitalization
  • Treatment outside India.
  • Suicide or self-inflicted injury or illness

BSLI Saral Health Plan

Offering a sum insured of Rs 10 lakh under the basic plan, the insurer also coves dental expenses.

  • Basic Plan: Under this individual health plan, all regular medical expenditures are covered. It has a maximum entry age of up to 65 years.
  • Dental Insurance: The policy covers dental treatment incurred due to dental care, regular dental check-ups, and surgeries.

Features of BSLI Saral Health Plan

Some of the common features include:

  • It covers hospitalization bills for both surgical and non-surgical cases
  • It covers critical illness in which a lump-sum amount is paid plus hospitalization cash benefits, on the diagnosis of a critical illness
  • The plan has routine health check-up options
  • The policy has extended coverage for dental care, pathology expenses, and such other costs
  • The policy comes with health reimbursement benefits. It can be availed by paying additional premium after 5 policy years
  • Enhanced health benefits are available which can be added to the policy by paying additional premium
  • This plan has minimum guaranteed addition for every additional premium paid
  • There is no need for any medical tests in this plan
  • The whole life plan has fund value. The plan continues till 100% of the fund value is paid
  • The leftover fund value is paid to the nominee on death of the policyholder

Benefits of BSLI Saral Health Plan

There is a medical benefit on this plan which is as follows:

  • Hospitalization Benefit— is paid up to:
    • Rs 2,000 for hospitalization and no surgery
    • Rs 4,000 for surgery and hospitalization
    • Rs 8,000 for surgeries related to brain, heart (including coronary arteries), liver or lung
  • Critical Illness Benefit— In case of diagnosis of heart problems, cancer, stroke, and major organ transplant, Rs 20,000 is paid for recovery.
  • Health Reimbursement Benefit— For the below conditions or cases, 100% fund value can be used after a waiting period of 5 years.
    • General practitioner’s fees, medicines, and drugs
    • Pathology diagnostics expenses
    • Dental treatment
    • Ayurvedic and homeopathic treatment
  • Terminal Illness Benefit— If the person insured has a terminal illness, 100% of the fund value is withdrawn.
  • Income Tax Benefit – Tax benefits are availed section 80D

Exclusions of BSLI Saral Health Plan

The list of exclusions includes:

  • AIDS, HIV
  • Suicide
  • Self-treatment
  • Alcohol and drug abuse
  • Pre-existing illnesses have a waiting period
  • Treatment from an unregistered medical practitioner
  • Experimental treatment.

ICICI Prudential Health Save

This health care policy reimburses claims for various health care expenditures for consultation visits, medicines, diagnostic costs, and more. Dental costs due to treatments, dentist consultations, and surgeries like root canal are covered under this policy.

Features of ICICI Prudential Health Saver

Salient features of this policy include:

  • In this plan up to 75 years of age, the policy covers all medical expenditures incurred due to hospitalization.
  • The plan covers pre-existing illnesses after 2 years of waiting period.
  • Being a health plan, it reimburses the amount for hospitalization after 3 years of a waiting period for pre-existing illness.
  • It provides free health check-up after 2 years.
  • It provides 5% of the annual interest for every claim-free year up to a maximum of 25%
  • The plan has an option for continuing the cover for 5 years, even after stopping premiums.
  • It reimbursements the cost of
    • Medicines and Drugs
    • Diagnostic Expenses
    • Dental Expenses
    • Co-pays or deductibles as part of the medical insurance cover

Benefits of ICICI Prudential Health Saver

The policy benefits are as follows:

  • Hospitalization Benefit – It covers for hospitalization of the following:
    • Room and boarding
    • Doctor fees
    • ICU
    • Nursing expenses
    • 125 listed daycare procedures
  • It covers pre and post hospitalization expenses up to 30 and 60 days respectively
  • Emergency ambulance expenses are available
  • Health Savings Benefit – In this plan, it reimburses the cost of
    • Medicines and Drugs
    • Diagnostic Expenses
    • Dental Expenses
    • Co-pays or deductibles as part of the medical insurance cover and
    • Other miscellaneous medical expenses

Exclusions of ICICI Prudential Health Saver

Common exclusions are:

  • AIDS, HIV treatment costs
  • Suicide
  • Self-treatment
  • Alcohol and drug abuse
  • Pre-existing illnesses have a waiting period
  • Treatment from an unregistered medical practitioner
  • Experimental treatment costs

HDFC Ergo Health Maxima Health

It is a 1-year policy that comes with unique features such as the waiting period can be reduced by 1 year on continuous policy renewal, critical illness cover is allowed till 70 years of age of the policyholder, sum insured of Rs 3 lakh, lifelong renewability etc.

  • Basic Plan: The health insurance plan offers certain out-patient coverage for illnesses, and other ailments, along with the hospitalisation expenses.
  • Dental Insurance: It has special dental insurance. This plan covers specific dental treatments except for dental treatment due to accidents.

Features of HDFC Ergo Health Maxima Health

The salient features of the basic policy are:

  • Critical illness cover is available for major diseases like dialysis, organ transplant
  • There is a cumulative bonus available for every claim-free year
  • For availing cashless benefit, the person must inform 48 hours before hospitalization and within 24 hours for emergency hospitalization

Benefits of HDFC Ergo Health Maxima Health

The policy benefits offered under this policy are:

  • Expenses for hospitalization of more than 24 hours are paid.
  • A pre-hospitalization for a period of 30 to 60 days is covered.
  • Post hospitalization for a period of 60 to 90 days is covered.
  • The cover is available for 140-days care procedures are covered.
  • Domiciliary treatment cover is offered.
  • Donor treatments for an organ transplant are covered.
  • Ambulance charges up to Rs 2000 is covered.
  • Daily cash cover is provided for accommodation for amounts up to Rs 3000.
  • For adults accompanying a child's daily cash cover of Rs 9000 is paid.
  • It covers newborn babies up to 90 days.
  • The basic policy offers maternity expenses cover.
  • The predetermination of costs - This helps in having a treatment proposal that underlines the cost for the dental procedure. The policy provider will check
    • patient's eligibility
    • eligibility period
    • services covered

After the check, the policy will either cover the partial payment or cover the entire amount.

Exclusions of HDFC Ergo Health Maxima Health

Some of the common exclusions applied to this policy are:

  • There is a waiting period of 30 days for all hospitalization except accidental injury
  • A 3 year waiting period for pre-existing is applicable
  • A 2 year waiting period for hernia, cataract, joint replacement, and hydrocele surgery is applicable
  • AIDS and HIV is not covered
  • Mental disorder, congenital diseases, cosmetic surgery, and weight control is not applicable
  • Hospitalization from drugs and alcohol excluded
  • Hospitalization due to war or biochemical weapons is excluded

SBI Life Smart Insurance

The sum insured ranges from Rs 1 to 5 lakh, this policy from SBI Life covers dental expenses as well as an in-built option. It is a comprehensive plan with health benefits like hospitalization surgical benefits, daycare treatments, and accidental hospitalization.

Under its dental insurance option, it covers all necessary dental expenses, which are not caused by accidents.

Features of SBI Life Smart Insurance

The policy comes with the following features:

  • Co-payment is available on claims for hospitalization in non-network hospitals with 10% on claims
  • Cashless facility available at network hospitals
  • Special coverage is available for
    • Day Care
    • Surgery with the hospitalization of fewer than 24 hours like
      • Chemotherapy
      • Dialysis
      • Radiotherapy
      • Dental Surgery
      • Tonsillectomy
      • Eye Surgery
    • Room, boarding and nursing charges are covered
    • Add-on covers are available for conditions like zero sub-limits on ICU and room rent, doctor fees, etc.

Benefits of SBI Life Smart Insurance

The policy benefits to be availed are:

  • Cashless treatment is available at a network of 3000+ hospitals across India
  • Income Tax benefit can be availed under Section 80D of the Indian Income Tax Act for premiums paid
  • Health check-ups are offered for free for every 4 claim-free years
  • Pre hospitalization costs for 30 days before hospitalization are covered
  • Post hospitalization costs for 60 days post hospitalization are covered
  • There is a waiting period of 1 year for specified diseases
  • Guaranteed renewal
  • Ambulance charges are covered
  • Domiciliary charges are covered

Exclusions of SBI Life Smart Insurance

The policy doesn’t offer coverage for the following:

  • For pre-existing diseases, there is a waiting period of 4 years
  • Illness, diseases or injury incurred within 30 days from the commencement of the policy will not be covered
  • non-allopathic medicine treatment is not covered.
  • A waiting period of 1 year is necessary for coverage of diseases like hernia, hydrocele, piles, etc.
  • Maternal care not covered
  • Hospitalization due to drugs and alcohol is not covered
  • Joint replacement surgery has a waiting period of 3 years
  • Congenital diseases are not covered

Inclusions of Dental Insurance Policy

The list of inclusions under dental insurance policy includes:

  • Some of the plans cover diagnostic, preventive, or emergency services or all of them.
  • These policies cover routine treatment for dental procedures.
  • The policy covers all the major dental care procedures.
  • There is no limit on the number of times of consultation.
  • The policy can be availed as rider benefit, along with the basic health insurance policy

Claim Process of Dental Insurance Plan

For availing cashless hospitalization & dental surgeries, follow the below steps:

  • Inform the policy provider about planned hospitalization in advance for pre-authorization. For emergencies, the policy provider must be informed within 24 to 72 hours of hospitalization at the network hospital.
  • At the time of reporting to the hospital, show the following documents at the helpdesk of the hospital.
    • Pre-authorization letter
    • Health card issued by the policy provider
    • ID proof, policy document to the network hospital to avail the cashless treatment facility
  • The hospital will send the details to the policy provider for authorization.

Then the company will inform whether the claim is accepted or rejected.

Reimbursement Process For Dental Insurance

If one wants to avail treatment process at a hospital which is not under the insurance provider's list of the network hospital, the below steps should be followed:

  • The person insured must inform the policy provider company before 48 hours of hospitalization for emergency treatment or planned hospitalization.
  • Start the treatment and pay the incurred expenses on own.
  • Fill the claim form and send it to the policy provider company with the documents listed below within 30 days of dental treatment.

Once the documents are verified, the policy provider will settle the claim.

Documents Required to Claim Dental Insurance

Common documents required to claim dental insurance include:

  • Aadhaar card and PAN card copies
  • All original laboratory and diagnostic test reports
  • Claim settlement letter for partial settlement
  • Duly signed claim and NEFT form
  • A first consultation letter from the doctor
  • For a cataract operation, IOL Sticker will have to be enclosed
  • Original hospital discharge card
  • Original hospital bill with detailed break up of all expenses including all charges or dentist prescriptions

Renewal Process of Dental Insurance Plan 

All dental policies are issued for one year. If one wants to increase the sum insured, it can be done at the time of renewal. The policyholder gets 30 days from the date of expiry as a grace period to renew the policy. The renewal process can be completed by visiting Paisawiki.com within a few minutes. The renewal steps are as follows:

  • Visit the official website at com.
  • Select the renewal option and enter the policy number.
  • Enter the date of birth and other relevant details.
  • Click on the ‘Submit’ option and then choose annual premium to be paid.
  • Click on the ‘Pay’ option to pay the premium amount.

The renewed policy will be emailed to the policyholder instantly.

How to Buy a Dental Insurance Plan?

There are multiple options available for buying the dental health plan - online and offline are being the most prominent ones.

Steps to follow for online purchase

  • Visit the paisawiki.com
  • Step 1: Select the health insurance option. Click on 'Get Quote.'
  • Step 2: Enter the type of protection plan required, number of family members for which protection is required, age, mobile number, and email. Click on 'check products.'
  • Step 3: On the next page, select the suitable policy.
  • Step 4: One can choose to compare with other dental plans or click 'buy a plan.'
  • Step 5: The website has a premium calculator. Select the sum insured, policy tenure, and room type. After selection, the above click 'proceed.'
  • Step 6: Choose additional dental covers if one wants extra protection. The website has an online premium calculator, which adds premium automatically on selection. Click 'Proceed Selection.'
  • Step 7: Add policyholders and nominee details.
  • Step 8: Add professional details.
  • Step 9: Select a member-specific declaration.
  • Step 10: Select 'I agree to the above declaration' to proceed.
  • Step 11: Proceed with payment.

After payment, the policyholder will get the policy documents mailed. For the offline process, one has to visit the nearest branch of the insurance provider.

Documents Required to Buy Dental Insurance Plans

The documents required are:

  • Age Proof: Birth Certificate, School/College Certificate, PAN card, Voter Card, Adhaar Card, Passport, Driving License and such documents
  • Address Proof: Ration Card, Electricity Bill, Bank A/C statement, Passport, Utility Bill, Telephone Bill, Postpaid Bill or Letter from Recognized Public Authority
  • Photo Identity Proof: Aadhar Card, Voter ID, PAN Card, Driving License, Passport or Public Servant with Photograph
  • Recent passport size photograph
  • Health record is required for a person above 60 years of age
  • Medical tests are also conducted for a person above 60 years of age

Health Insurance FAQ’s

  • Q. Are riders available with a dental insurance plan?

    Ans: Yes, riders are available with dental policy. By paying an additional premium, the person insured can cover for accidental hospitalization charges for dental surgeries. The claim for such treatments will be reimbursed, which is subject to a maximum limit. There are various other medical schemes available in the policy as riders.
  • Q. Who can be covered under these policies?

    Ans: A maximum of six people who are self, spouse, dependent children, and parents can be covered under this floater policy.
  • Q. Are there any pre-policy medical tests required for buying the policy?

    Ans: If the age policyholder is below 60 years of age, then there is no need for medical tests if the policyholder doesn't have any pre-existing illness.

    However, if a policyholder is above 60 years of age, then medical tests need to be done. If the policy is accepted, then 50% of the expenses will be reimbursed by the insurance company, if it is offered.

  • Q. What is the renewal age under this plan?

    Ans: For the policyholders, their spouse, and dependent parents, the plan has a lifelong renewability option. For dependent children, the policy is renewable up to 35 years.
  • Q. How much GST is charged for the plan?

    Ans: A GST of 18% is charged for this plan.
Written By: Paisawiki - Updated: 05 October 2020
Disclaimer: Paisawiki does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.